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Primum Nil Nocere

Primum Nil Nocere is a Latin phrase that translates to "First Do No Harm". It's an axiom that every healthcare student is taught very early on in their academic careers, and it's a great rule of thumb for instances where actually doing something would cause more harm than good.

Because sometimes it's better to do nothing.

Which is what I wish Gabrielle Glaser had considered doing before submitting her op-ed piece to the New York Times entitled COLD TURKEY ISN'T THE ONLY ROUTE. In it, she lambastes 12-step programs (while sucker-punching the alcohol treatment community) and posits that there are other ways to "change your drinking habits". And this, I feel, is just sloppy and irresponsibile. Even if we exclude the fact that, at no point in time does she herself identify herself as someone who has successfully overcome a drinking problem (bear in mind, this is a woman who made a pretty penny herself by writing and publishing a book on why women drink and how they "regained control"), we still need to sit back and ask ourselves, "Who, exactly, is this helping?"

In my 20 years as an addiction specialist, working with addicts and alcoholics, I can tell you that—although her flowery words sound like a solution to a drinking problem—her theories are so destructive, I cannot fathom her being able to sleep at night knowing that women are reading what she wrote and buying into the lie that if they take a pill, or visit a website and make a promise, then all of their problems will magically go away and they will be able to drink and function as normal people do.

But, as anyone with a drinking problem will attest, alcoholics are nothing like normal people. As a matter of fact, this desperate attempt to BE like normal people has led many an alcoholic to an early grave.

Imagine if you will, dragging Ms. Glaser by the hair down a hospital corridor and shutting her in a room with a mother-of-four whose skin is yellow from cirrohsis of the liver and telling her to explain to this woman that if she could only drink in moderation, her life would be amazing. Or shoving Ms. Glaser into a mental institution where women are wailing in agony after having lost careers to their incessant need to drink and having her explain to them that there is a pill that would allow them to drink and not feel the effects and then follow the women around to make sure that they are taking it.

Because that's the thing about alcoholism: every alcoholic I've ever encountered is a constellation of reasons and urges and compulsions to drink, each of which has to be addressed if the alcoholic is to be successfully treated.

What is laughable is how Ms. Glaser covers her ass by saying, "This approach isn't for severely dependent drinkers, for whom abstinence might be best", which begs the question, "Who else could possibly be clamoring for a magic pill to help them control and enjoy their drinking?"

And who exactly is she helping? Because, I promise you, the only people buying into what Ms. Glaser is selling are people who are unwilling to stop, regardless of the consequences of their drinking (which, by the way, is the layman's definition of an alcoholic).

It is disgusting to me (and irresponsible on her part) that she would promote the idea that there are other ways to change your drinking habits without ever having lived in the trenches with the millions of people suffering from this horrendous malady. Her "researches" show that hers is a valid point but, to my liking, I am sure there is "research" out there that proves without argument that the Nazis were justified in their attempted genocide.

That doesn't make what they were doing right. And I've always relied on The New York Times (our Gold Standard of serious and conscientious reporting) to weed out opinions like this. It is disappointing to see her careless views tarnish the Times' reputation.

Because, to my sensibilities, Primum Nil Nocere absolutely applies here. And it is my sincerest hope that Gabrielle Glaser takes the axiom to heart and goes back to doing nothing. And her belief that "mistakes can be lessons, not failures" doesn't apply here, unless she, herself, wants to be the one to explain to a six year old child why their mother died clawing at the glass in a fiery wreck, because she didn't feel like taking her pill that night.

The problem is that everyone with a drinking problem can be labeled as an alcoholic. However,I believe the majority are not. Would you tell every obese person that they could never again eat a piece of chocolate cake? No? Then why would you ever tell someone who drinks that they could never drink again? It doesn't make sense and its not realistic for everyone.

I also believe there are people, like myself, who cannot moderate. But in what way is 12-step treatment scientific? If you really go by the "first do no harm" idea, that would really eliminate the 12 step community as a treatment for addiction since a LOT of harm is done within these communities and the recovery rate is horrendous.

Is it ever going to be possible for the treatment industry to move into more scientific treatment methods and away from 12-step? Right now I don't see how the industry can complain about people writing books offering other points of view when they cling to a treatment method created by lay people in 1938, one which refuses to change one single word no matter what new information may be discovered.

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The NIAAA (National Institute on Alcohol Abuse and Alcoholism) is pretty credible in the addiction field. You might even say they are an authority.
(By the way, I know you know who the NIAAA is, I thought it might help other readers who might not.)

There are other article on this but I think you would want to read the real study and not someone's interpretation of it.

As for the Op-Ed piece, by definition it is a opinion piece. I read it and was familiar with everything cited as proof.

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